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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2008

Open Access 01-12-2008 | Research article

The influence of expectation on spinal manipulation induced hypoalgesia: An experimental study in normal subjects

Authors: Joel E Bialosky, Mark D Bishop, Michael E Robinson, Josh A Barabas, Steven Z George

Published in: BMC Musculoskeletal Disorders | Issue 1/2008

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Abstract

Background

The mechanisms thorough which spinal manipulative therapy (SMT) exerts clinical effects are not established. A prior study has suggested a dorsal horn modulated effect; however, the role of subject expectation was not considered. The purpose of the current study was to determine the effect of subject expectation on hypoalgesia associated with SMT.

Methods

Sixty healthy subjects agreed to participate and underwent quantitative sensory testing (QST) to their leg and low back. Next, participants were randomly assigned to receive a positive, negative, or neutral expectation instructional set regarding the effects of a specific SMT technique on pain perception. Following the instructional set, all subjects received SMT and underwent repeat QST.

Results

No interaction (p = 0.38) between group assignment and pain response was present in the lower extremity following SMT; however, a main effect (p < 0.01) for hypoalgesia was present. A significant interaction was present between change in pain perception and group assignment in the low back (p = 0.01) with participants receiving a negative expectation instructional set demonstrating significant hyper algesia (p < 0.01).

Conclusion

The current study replicates prior findings of c- fiber mediated hypoalgesia in the lower extremity following SMT and this occurred regardless of expectation. A significant increase in pain perception occurred following SMT in the low back of participants receiving negative expectation suggesting a potential influence of expectation on SMT induced hypoalgesia in the body area to which the expectation is directed.
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Metadata
Title
The influence of expectation on spinal manipulation induced hypoalgesia: An experimental study in normal subjects
Authors
Joel E Bialosky
Mark D Bishop
Michael E Robinson
Josh A Barabas
Steven Z George
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2008
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-9-19

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